JP2017140114A - Arthritis therapeutic method and arthritis therapeutic system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an arthritis therapeutic method capable of expecting a pain relief effect in a short period, and to provide an arthritis therapeutic system.SOLUTION: An arthritis therapeutic method includes: an instrument introduction step S11 for allowing at least one instrument 120 having a tube shape to communicate with a lesion 1 where crystal-induced arthritis is caused; and a therapeutic step S12 for removing a causative substance of the crystal-induced arthritis from the lesion by perfusion and discharge of cleaning fluid passing through the instrument.SELECTED DRAWING: Figure 2

Description

  The present invention relates to an arthritis treatment method and an arthritis treatment system.

  In recent years, gout, which is a representative example of crystal-induced arthritis, has been increasing year by year, and the number of manifest patients alone has reached 1 million.

  Gout develops as a causative substance such as a crystal of urate accumulated in the joints, and a chemical substance released by phagocytosis of white blood cells and the like, accompanied by intense pain, swelling, and heat.

  For the treatment of gout, administration of a drug is common, but for example, perfusion of a drug to a lesion site like treatment of cancer in Patent Document 1 has not been established.

Special table 2009-529992

  When a gout attack (severe pain) develops, at present, the only way to cope is to stay calm for about 1 to 7 days until the attack subsides by drug administration, and the patient must endure severe pain for many hours.

  Therefore, the present invention has been made in view of such problems, and an object thereof is to provide an arthritis treatment method and an arthritis treatment system that can be expected to have an analgesic effect in a short period of time.

  In order to achieve the above object, the arthritis treatment method of the present invention comprises an instrument introduction step of communicating at least one instrument having a tube shape with a lesion site where crystal-induced arthritis has occurred, and a causative substance of the crystal-induced arthritis Removing from the lesion site by perfusion and drainage of a lavage fluid through the instrument.

  An arthritis treatment system according to the present invention for achieving the above object is used for the treatment of crystal-induced arthritis, comprising a washing liquid supply unit that supplies a washing liquid under pressure, and a communication between the washing liquid supply unit and a lesion site. And at least one instrument having a tube shape that allows communication between the lesion site and the outside of the body.

  According to the arthritis treatment method and the arthritis treatment system having the above-described configuration, the causative substance at the lesion site is directly removed, so that a pain relief effect can be expected in a short period of time.

It is a figure which shows schematic structure of the arthritis treatment system of 1st Embodiment. It is a flowchart of the arthritis treatment method of 1st Embodiment. It is a figure which shows the state by which the puncture device of 1st Embodiment was punctured to the lesion site | part. It is a figure which shows perfusion and discharge | emission of the washing | cleaning liquid through the puncture device of 1st Embodiment. It is a figure which shows extraction of the puncture device of 1st Embodiment. It is a figure which shows schematic structure of the arthritis treatment system of 2nd Embodiment. It is a figure which shows perfusion and discharge | emission of the washing | cleaning liquid through two catheters of 2nd Embodiment. It is a figure which shows schematic structure of the arthritis treatment system of 3rd Embodiment. It is a flowchart of the arthritis treatment method of 3rd Embodiment. It is a figure which shows the communication to the lesioned part of the catheter of 3rd Embodiment. It is a figure which shows injection | pouring of the gel-like substance through the catheter of 3rd Embodiment. It is a figure which shows insertion to the wound of the puncture device of 3rd Embodiment. It is a figure which shows the state by which the puncture device of 3rd Embodiment was inserted between the gel-like substance and the lesioned part.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and differs from an actual ratio.

<First Embodiment>
As shown in FIG. 1, the arthritis treatment system 100 of 1st Embodiment has the washing | cleaning-liquid supply part 110 and the puncture tool 120 (one instrument which has a tube shape).

  The cleaning liquid supply unit 110 supplies the cleaning liquid to the puncture tool 120 under pressure. The cleaning liquid is, for example, physiological saline, Ringer's liquid, Hanks' liquid, or the like, but is not particularly limited as long as it is a liquid having biocompatibility.

  The cleaning liquid supply unit 110 only needs to supply the cleaning liquid to the puncture tool 120 under pressure, and is a syringe, for example, but is not limited thereto. The cleaning liquid supply unit 110 may include, for example, a storage unit that stores the cleaning liquid and a pump that pressurizes the cleaning liquid from the storage unit to the puncture tool 120.

  The puncture device 120 includes a needle 121, a main body portion 122, a first hub portion 123, and a second hub portion 124.

  The needle 121 has a tube shape in which two lumens 121a and 121b are formed. The needle 121 has a sharp tip inclined with respect to the axial direction. The lumens 121 a and 121 b penetrate the tip of the needle 121.

  The main body portion 122 is a shaft-like member, and a needle 121 is provided at one end, and a first hub portion 123 is provided at the other end. The lumens 121 a and 121 b extend to the first hub portion 123 through the main body portion 122.

  The first hub part 123 is freely connectable to the cleaning liquid supply part 110. Further, the second hub portion 124 branches from the first hub portion 123.

  The lumen 121 a communicates with the cleaning liquid supply unit 110 through the main body portion 122 and the first hub portion 123. The cleaning liquid supplied under pressure from the cleaning liquid supply unit 110 is discharged from the tip of the needle 121 through the lumen 121a. The lumen 121b communicates with the outside through the main body 122, the first hub 123, and the second hub 124. The lumen 121a and the lumen 121b are separated from each other and do not communicate with each other.

  Next, the arthritis treatment method according to the first embodiment will be described assuming that gout develops in the joint of the foot.

  As shown in FIG. 2, the arthritis treatment method of 1st Embodiment has instrument introduction | transduction step S11, treatment step S12, and post-treatment step S13. The arthritis treatment method of the present embodiment is performed using the above-described arthritis treatment system 100, and is preferably performed when a gout attack (severe pain) occurs.

  If treatment is given during a calm period when no seizures occur, seizures may be induced along with the treatment, but such induction can be prevented by giving treatment during the seizures.

  As shown in FIG. 3, in the instrument introduction step S <b> 11, the surgeon communicates the puncture tool 120 to the lesion site 1 where gout has occurred. In the present embodiment, the lesion site 1 is a joint between the first metatarsal bone 2 and the proximal phalanx 3. The surgeon stabs the needle 121 toward the lesion site 1 and causes the puncture tool 120 to communicate with the lesion site 1.

  Thereafter, in the treatment step S12, the causative substance of gout is removed from the lesion site 1 by perfusing and discharging the cleaning liquid through the puncture device 120.

  As shown in FIG. 4, the washing liquid is slightly pressurized and released from the lumen 121 a and perfused into the lesion site 1. Perfusion means flowing fluid into a specific part of the body.

  Since the pressure in the vicinity of the lesion site 1 is increased by the weakly pressurized injection of the cleaning fluid, the cleaning fluid containing the causative substance of the lesion site 1 flows into the lumen 121b as waste fluid and is discharged out of the body through the lumen 121b as it is. As a result, the causative substance is removed from the lesion site 1. The waste liquid discharged outside the body may be collected by a collection unit such as a beaker.

  The causative substance of the lesion site 1 is a uric acid crystal (free uric acid crystal) separated around the joint, and a chemical substance released by phagocytosing the crystal by white blood cells. After removal of the causative substance, a post-treatment step S13 is performed.

  As shown in FIG. 5, in the post-treatment step S <b> 13, the operator removes the puncture tool 120 from the foot and closes the wound 4 formed by the puncture tool 120 by, for example, suturing.

  Next, the function and effect of this embodiment will be described.

  Unlike this embodiment, when a gout attack is suppressed by administration of a drug, the patient must withstand severe pain for hours until the drug is effective. On the other hand, according to the present embodiment, the causative substance is removed by perfusion and discharge of the washing liquid, and the lesioned part 1 is directly treated, so that a pain relief effect can be expected in a short period of time.

  Moreover, according to this embodiment, since the puncture tool 120 having a tube shape is communicated with the lesioned site 1 and the treatment is performed, it is not necessary to make a large incision in the lesioned site 1 and the burden on the patient can be reduced.

  In particular, the arthritis treatment system 100 according to the present embodiment has one puncture tool 120 through which treatment is performed, so that only one small wound 4 needs to be formed, and the burden on the patient can be more effectively reduced. Can be reduced.

  Further, among crystal-induced arthritis caused by crystals deposited on joints, the burden on a larger number of patients can be reduced by applying this embodiment particularly to gout with a large number of patients.

Second Embodiment
As shown in FIG. 6, the arthritis treatment system 200 according to the second embodiment includes a washing liquid supply unit 110, a suction unit 210, and two catheters 220 and 230 (two instruments having a tube shape).

  Since the cleaning liquid supply unit 110 is the same as that of the first embodiment, the same reference numerals as those of the first embodiment are attached, and the duplicate description here is omitted. The suction unit 210 may be anything that can suck the air in the catheter 230 and the cleaning liquid after cleaning the affected part, and is, for example, a syringe or a pump, but is not limited thereto.

  The catheter 220 has a main body part 221 and a hub part 223.

  The main body 221 is a flexible tubular member in which one lumen 221a is formed. The lumen 221a penetrates the main body 221 in the axial direction.

  The hub part 223 is provided at one end of the main body part 221, and communicates with the lumen 221a. The hub part 223 can be freely connected to the cleaning liquid supply part 110. The lumen 221 a communicates with the cleaning liquid supply unit 110 through the hub portion 223. The cleaning liquid supplied under pressure from the cleaning liquid supply unit 110 is discharged from the tip of the main body 221 through the lumen 221a.

  The catheter 230 has the same configuration as the catheter 220, but differs from the catheter 220 in that it is connected to the suction unit 210. The configuration of the main body 231 is the same as the configuration of the main body 221. The configuration of the hub portion 233 is substantially the same as that of the hub portion 223, but is different in that it can be connected to the suction portion 210.

  A lumen 231 a formed in the main body portion 231 passes through the main body portion 231 in the axial direction, and communicates with the suction portion 210 through the hub portion 233. The suction part 210 is connected to the hub part 233 and sucks the air in the lumen 231a and the cleaning liquid after cleaning the affected part.

  Next, the arthritis treatment method of this embodiment is described.

  Although the arthritis treatment method of 2nd Embodiment has three steps S21-S23 like 1st Embodiment (refer FIG. 2), the specific technique performed by each differs from 1st Embodiment.

  As shown in FIG. 7, in the instrument introduction step S <b> 21, the operator causes the two catheters 220 and 230 to communicate with the lesion site 1. The lesion site 1 is the same as in the first embodiment.

  The surgeon forms two small wounds 5, 6 in the vicinity of the lesion site 1, and communicates the catheters 220, 230 to the lesion site 1 through the wounds 5, 6.

  Thereafter, in the treatment step S <b> 22, the causative substance of gout is removed from the lesion site 1 by perfusing the washing solution through one catheter 220 and discharging the washing solution through the other catheter 230.

  The surgeon alternately perfuses the cleaning liquid through the catheter 220 and discharges the cleaning liquid through the catheter 230, but they may be performed simultaneously.

  The washing liquid is weakly pressurized and released from the lumen 221a, and perfused into the lesion site 1. The cleaning liquid containing the causative substance of the lesion site 1 is sucked through the lumen 231a and discharged as a waste liquid to the suction unit 210 outside the body. The suction unit 210 may be in communication with a recovery unit such as a tank for storing waste liquid, and the waste liquid can be recovered by such a configuration.

  After the perfusion and discharge of the cleaning liquid are alternately repeated a plurality of times, a post-treatment step S23 is performed. In the post-treatment step S23, the operator removes the catheters 220 and 230 from the foot and closes the wounds 5 and 6 with, for example, sutures.

  Next, the effect of this embodiment is described.

  The arthritis treatment system 200 of the present embodiment has two catheters 220 and 230, and the catheters 220 and 230 are used separately for perfusion and drainage of the washing liquid. Accordingly, the cleaning liquid and the waste liquid can be passed through the larger lumens 221a and 231a, so that the cleaning liquid perfusion function and the discharge function can be further improved.

  Further, the present embodiment includes the same configuration as that of the first embodiment, and the operational effects achieved by this are the same as those of the first embodiment.

<Third Embodiment>
As shown in FIG. 8, the arthritis treatment system 300 according to the third embodiment includes a washing liquid supply unit 110, a gel supply unit 310, a puncture device 120, and a catheter 320 (a device having a tube shape communicating with the gel supply unit). And having.

  Since the cleaning liquid supply unit 110 and the puncture device 120 are the same as those in the first embodiment, the same reference numerals as those in the first embodiment are used, and the description thereof is omitted here.

  The gel supply unit 310 supplies a gel substance to the catheter 320 under pressure. Examples of the gel-like substance include, but are not limited to, a steroid agent such as triamcinolone acetonide and dexamethasone sodium phosphate, or an anti-inflammatory agent such as methotrexate and aspirin, and a contrast agent. Moreover, it is desirable that the gel substance has biodegradability.

  The gel supply unit 310 only needs to supply a gel substance to the catheter 320 under pressure, and is a syringe, for example, but is not limited thereto. The gel supply unit 310 may include, for example, a storage unit that stores a gel-like substance, and a pump that pressurizes the gel-like substance from the storage unit to the catheter 320.

  The catheter 320 has a main body portion 321 and a hub portion 323.

  The main body 321 is a flexible tubular member in which a lumen 321a is formed. The lumen 321a penetrates the main body 321 in the axial direction.

  The hub portion 323 is provided at one end of the main body portion 321 and communicates with the lumen 321a. The hub part 323 can be freely connected to the gel supply part 310. The lumen 321 a communicates with the gel supply unit 310 through the hub portion 323. The gel-like substance supplied under pressure from the gel supply unit 310 is released from the tip of the main body 321 through the lumen 321a.

  Next, the arthritis treatment method of this embodiment is described.

  As shown in FIG. 9, the arthritis treatment method of the third embodiment includes a gel injection instrument introduction step S30a, a gel injection step S30b, an instrument introduction step S31, a treatment step S32, and a post-treatment step S33. Have.

  The arthritis treatment method of the present embodiment differs from the first embodiment in that it includes a gel injection device introduction step S30a and a gel injection step S30b before the device introduction step S31, but each of the other steps S31 to S33 is The steps are substantially the same as steps S11 to S13 of the first embodiment.

  As shown in FIG. 10, in the gel injection device introduction step S30a, the operator places an introducer sheath 340 in a small wound 7 formed in the vicinity of the lesion site 1 and inserts the catheter 320 through this to introduce the catheter 320 into the lesion site. Communicate with 1. The lesion site 1 is the same as in the first embodiment.

  As shown in FIG. 11, in the gel injection step S <b> 30 b, the operator injects a gel substance toward the lesion site 1 from the catheter 320 communicated with the lesion site 1. After the injection of the gel substance, the operator removes the catheter 320 while the introducer sheath 340 is left in place, and performs the instrument introduction step S31.

  As shown in FIG. 12, in the instrument introduction step S <b> 31, the puncture tool 120 is inserted through the introducer sheath 340 that is left in the wound 7 and communicated with the lesion site 1. By doing so, it is not necessary to form a new wound, so the burden on the patient can be reduced. Moreover, since the puncture device 120 is guided by the introducer sheath 340, the puncture device 120 can be easily inserted.

  As shown in FIG. 13, the gel-like substance 301 is injected so as to cover the lesion site 1, and the puncture instrument 120 is inserted between the gel-like substance 301 and the lesion site 1 in the instrument introduction step S31. The In this state, treatment step S32 is performed.

  The treatment step S32 is the same as the treatment step S12 of the first embodiment, and the irrigation liquid is perfused and discharged through one puncture tool 120, and the causative substance is removed from the lesion site 1. Thereafter, a post-treatment step S33 similar to the post-treatment step S13 of the first embodiment is performed.

  According to the present embodiment, the lesioned part 1 is covered with the gel substance 301, and the washing liquid is perfused and discharged between them. Therefore, the washing liquid is difficult to diffuse from the lesioned part 1 to other places, and the causative substance The removal effect can be further enhanced.

  Further, the present embodiment includes the same configuration as that of the first embodiment, and the operational effects achieved by this are the same as those of the first embodiment.

  The present invention is not limited to the above-described embodiments, and various modifications can be made within the scope of the claims.

  For example, in the above-described embodiment, one puncture tool 120 and two catheters 220 and 230 are disclosed as preferable examples of a device for performing perfusion and drainage of a washing solution, but the present invention is not limited to these forms. The present invention also includes a mode in which the cleaning liquid is perfused and discharged using three or more instruments having a tube shape.

  The arthritis treatment system 200 of the second embodiment may include the gel supply unit 310 and the catheter 320 of the third embodiment.

  In addition, the treatment target of the present invention is not limited to gout, and may be other crystal-induced arthritis caused by crystals deposited on joints such as pseudogout and basic calcium phosphate (BCP) crystal deposition disease.

  Further, the lesion site is not limited to the above embodiment, and may be another joint different from the above embodiment in the foot, for example, knee, waist, shoulder, elbow, hand, sternum, etc. It may be a joint of a part.

1 lesion site,
2 First metatarsal bone,
3 proximal phalanx,
4, 5, 6, 7 wounds,
100 arthritis treatment system,
110 Cleaning liquid supply unit,
120 puncture device (one instrument having a tube shape),
121 needles,
121a One lumen,
121b Other lumens,
122 body part,
123 first hub part,
124 second hub part,
200 Arthritis treatment system,
210 suction part,
220 catheter (one of two instruments having a tube shape),
221 body part,
221a lumens,
223 hub part,
230 catheter (the other of the two instruments having a tube shape),
231 body,
231a lumens,
233 hub part,
300 Arthritis treatment system,
301 gel material,
310 gel supply unit,
320 catheter (apparatus having a tube shape communicating with the gel supply unit),
321 body part,
321a lumens,
323 hub part,
340 Introducer sheath,
S11, S21, S31 Instrument introduction step,
S12, S22, S32 treatment steps,
S13, S23, S33 post-treatment steps,
S30a Gel injection device introduction step,
S30b Gel injection step.

Claims (10)

An instrument introduction step of communicating at least one instrument having a tube shape with a lesion site where crystal-induced arthritis has occurred;
A treatment step of removing the causative substance of the crystal-induced arthritis from the lesion site by perfusion and drainage of a washing solution through the device. In the instrument introduction step, one instrument is communicated with the lesion site,
The arthritis treatment method according to claim 1, wherein in the treatment step, the causative substance is removed by the perfusion and the drainage through one instrument. In the instrument introduction step, two instruments are communicated with the lesion site,
The method for treating arthritis according to claim 1, wherein in the treatment step, the causative substance is removed by the perfusion through one of the two instruments and the discharge through the other instrument. Before the instrument introduction step, has a gel injection step of injecting a gel-like substance toward the lesion site,
The arthritis treatment method according to any one of claims 1 to 3, wherein in the instrument introduction step, the instrument is inserted between the gel substance and the lesion site.   The method for treating arthritis according to any one of claims 1 to 4, wherein the crystal-induced arthritis is gout. An arthritis treatment system used for the treatment of crystal-induced arthritis,
A cleaning liquid supply unit for supplying the cleaning liquid under pressure;
An arthritis treatment system comprising: at least one instrument having a tube shape that enables communication between the cleaning liquid supply unit and a lesion site, and communication between the lesion site and the outside of the body. Having one said instrument having a tube shape;
The arthritis treatment system according to claim 6, wherein the one device is formed with one lumen communicating with the cleaning liquid supply unit and another lumen separated from the one lumen and communicating with the outside. Having two said instruments having a tube shape;
7. A lumen communicating with the cleaning liquid supply unit is formed in one of the two instruments, and a lumen communicating with the outside of the instrument is formed in the other instrument. The described arthritis treatment system. A gel supply unit for supplying a gel substance;
The arthritis treatment system of any one of Claims 6-8 which has an instrument which has a tube shape connected to the said gel supply part.   The arthritis treatment system according to any one of claims 6 to 9, wherein the crystal-induced arthritis is gout.